This Life Events Guide page has two sections - active employees and retirees. Please refer to the appropriate page section for information based on your employment status. This life event does not apply to survivors.

In the table(s) below, supplemental benefits refer to supplemental dental insurance (Select, Select Plus, and Preventive), vision insurance, and Accident Plan. You may not be eligible for all supplemental benefits. Visit the Dental Insurance, Vision Insurance, and Accident Plan pages to learn about eligibility.

For Active Employees

You have a new dependent due to:

Birth, Adoption, or Placement for Adoption - Active Employees

 Health Insurance & Uniform DentalSupplemental Benefits
Enrollment opportunity?

Yes, also includes birth of grandchild from your covered dependent under age 18

(Your grandchild becomes ineligible at the end of the month in which the parent, your dependent, turns age 18)

Yes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?YesYes
Change coverage from family to individual?NoNo
Change health plan?Yesn/a
Drop a dependent and keep family coverage?NoNo
Cancel coverage?See the You Gain Eligibility for Other Group Medical Coverage page for more informationSee the You Gain Eligibility for Other Group Medical Coverage page for more information
Deadline to submit changes 

To enroll or add dependent: Within 60 days of the event

To change plans: Within 30 days of the event

To enroll or add dependent: Within 60 days of the event

To change plans: Within 30 days of the event

How to submit changes

Log in to My Benefits to edit your benefits:

  • Select "Birth" or "Adoption" as your reason for change.
  • Enter the date of birth, adoption, or placement for adoption.
  • Enroll or add dependents to your coverage.
  • Upload required documentation for newly added dependents.

Once you've made changes in My Benefits, reach out to your employer if you'd like to switch health plans.

Log in to My Benefits to edit your benefits:

  • Select "Birth" or "Adoption" as your reason for change.
  • Enter the date of birth, adoption, or placement for adoption.
  • Enroll or add dependents to your coverage.
  • Upload required documentation for newly added dependents.
Documentation required?YesYes
Effective date

New coverage: Effective on the date of the event

Plan change: Effective the first of the month on or after receipt of the application

New coverage: Effective on the date of the event

National Medical Support Notice (NMSN) - Active Employees

 Health Insurance & Uniform DentalSupplemental Benefits
Enrollment opportunity?YesYes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?YesYes
Change coverage from family to individual?NoNo
Change health plan?Yesn/a
Drop a dependent and keep family coverage?NoNo
Cancel coverage?See the You Gain Eligibility for Other Group Medical Coverage page for more informationYes, must provide proof you gained  coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit changes

To enroll or add dependent: Within 60 days of the event

To change plans: Within 30 days of the event

To enroll or add dependent: Within 60 days of the event

To change plans: Within 30 days of the event

How to submit changesSubmit the Health Insurance Application/Change Form (ET-2301) with required documentation for newly added dependents to your employer. Submit the Supplemental Insurance Application/Change (ET-2339) to with required documentation for newly added dependents to your employer. 
Documentation required?YesYes
Effective date

New coverage: Effective on the first of the month on or after receipt of the application, or the date specified on the NMSN, if one is specified

Plan change: Effective the first of the month on or after the receipt of the application

New coverage: Effective on the first of the month on or after receipt of the application, or the date specified on the NMSN, if one is specified

Paternity - Active Employees

 Health Insurance & Uniform DentalSupplemental Benefits
Enrollment opportunity?YesYes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?YesYes
Change coverage from family to individual?NoNo
Change health plan?Yesn/a
Drop a dependent and keep family coverage?NoNo
Cancel coverage?See the You Gain Eligibility for Other Group Medical Coverage page for more informationSee the You Gain Eligibility for Other Group Medical Coverage page for more information
Deadline to submit application To enroll or add dependent: Within 60 days of the event. Children born outside of marriage become dependents of the father on the date of the court order declaring paternity, on the date the acknowledgment of paternity is filed with the Department of Health Services (or equivalent if the birth was outside of the state of Wisconsin), or on the date of birth with a birth certificate listing the father's name

To change plans: Within 30 days of the event

To enroll: Within 60 days of the event

To cancel or change: Within 30 days of the event

How to submit changes

Within 60 days of birth: Log in to My Benefits to edit your benefits:

  • Select "Birth" as your reason for change.
  • Enter the date of birth.
  • Enroll or add dependents to your coverage.
  • Upload required documentation for newly added dependents.

Once you've made changes in My Benefits, reach out to your employer if you'd like to switch health plans.

More than 60 days after birth: Submit the Health Insurance Application/Change Form (ET-2301) with required documentation for newly added dependents to your employer. 

Within 60 days of birth: Log in to My Benefits to edit your benefits:

  • Select "Birth" as your reason for change.
  • Enter the date of birth.
  • Enroll or add dependents to your coverage.
  • Upload required documentation for newly added dependents.

More than 60 days after birth: Submit the Supplemental Insurance Application/Change (ET-2339) to with required documentation for newly added dependents to your employer. 

Documentation required?YesYes
Effective date

Birth certificate or statement of paternity is filed within 60 days of birth: New coverage is effective on date of birth

Application is filed more than 60 days after birth, without a birth certificate: New coverage is effective on the first of the month following the receipt of application

Plan change: Effective the first of the month on or after the receipt of the application

Birth certificate or statement of paternity is filed within 60 days of birth: New coverage is effective on date of birth

Application is filed more than 60 days after birth, without a birth certificate: New coverage is effective on the first of the month following the receipt of application

 Health Insurance & Uniform DentalSupplemental Benefits
Enrollment opportunity?YesYes
Change coverage from individual to family?YesYes
Change coverage from family to individual?NoNo
Change health plan?Yesn/a
Drop a dependent and keep family coverage?NoNo
Cancel coverage?See the You Gain Eligibility for Other Group Medical Coverage page for more informationSee the You Gain Eligibility for Other Group Medical Coverage page for more information
Deadline to submit application To enroll or add dependent: File an application with your employer within 60 days of the event

To change plans: File an application with your employer within 30 days of the event

To enroll: File an application with your employer within 60 days of the event

To change or cancel: File an application with your employer within 30 days of the event

How to submit changes

Log in to My Benefits to edit your benefits:

  • Select "Guardianship of child" as your reason for change.
  • Enter the date of guardianship.
  • Enroll or add dependents to your coverage.
  • Upload required documentation for newly added dependents.

Once you've made changes in My Benefits, reach out to your employer if you'd like to switch health plans.

Log in to My Benefits to edit your benefits:

  • Select "Guardianship of child" as your reason for change.
  • Enter the date of guardianship.
  • Enroll or add dependents to your coverage.
  • Upload required documentation for newly added dependents.
Documentation required?YesYes
Effective date

New coverage: Effective on the date of the event

Plan change: Effective the first of the month on or after the receipt of the application

New coverage: Effective on the date of the event

Custody Transfer - Active Employees

 Health Insurance & Uniform DentalSupplemental Benefits
Enrollment opportunity?YesYes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?YesYes
Change coverage from family to individual?NoNo
Change health plan?Yesn/a
Drop a dependent and keep family coverage?NoNo
Cancel coverage?See the You Gain Eligibility for Other Group Medical Coverage page for more informationSee the You Gain Eligibility for Other Group Medical Coverage page for more information
Deadline to submit application Within 30 days of the eventWithin 30 days of the event
How to submit changes

Log in to My Benefits to edit your benefits:

  • Select "Legal Custody of a Child" as your reason for change.
  • Enter the date of custody.
  • Enroll or add dependents to your coverage.
  • Upload required documentation for newly added dependents.

Once you've made changes in My Benefits, reach out to your employer if you'd like to switch health plans.

Log in to My Benefits to edit your benefits:

  • Select "Legal Custody of a Child" as your reason for change.
  • Enter the date of custody.
  • Enroll or add dependents to your coverage.
  • Upload required documentation for newly added dependents.
Documentation required?YesYes
Effective date

New coverage: Effective on the date of the event

Plan change: Effective the first of the month on or after the receipt of the application

New coverage: Effective on the date of the event

 

For Retirees

You have a new dependent due to:

Birth, Adoption, or Placement for Adoption - Retirees

 Health Insurance & Uniform DentalSupplemental Benefits
Enrollment opportunity?NoYes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?YesYes
Change coverage from family to individual?YesNo
Change health plan?Yesn/a
Drop a dependent and keep family coverage?NoNo
Cancel coverage?YesYes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit changes

To change to family coverage or add a dependent: Within 60 days of the event

To change plans or cancel: Within 30 days of the event

To enroll: Within 60 days of the event

To change or cancel: Within 30 days of the event

How to submit changesSubmit the Health Insurance Application/Change for Retirees (ET-2331) with required documentation to ETF.Submit the Supplemental Insurance Application/Change (ET-2339) with required documentation to ETF.
Documentation required?YesYes
Effective date

Coverage change: Effective on the date of the event

Plan change: Effective the first of the month on or after the receipt of the application

Canceling coverage: Effective the last day of the month following receipt of the application

Coverage change: Effective on the date of the event

Canceling coverage: Effective the last day of the month following receipt of the application

National Medical Support Notice (NMSN) - Retirees

 Health Insurance & Uniform DentalSupplemental Benefits
Enrollment opportunity?NoYes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?YesYes
Change coverage from family to individual?YesNo
Change health plan?Yesn/a
Drop a dependent and keep family coverage?NoNo
Cancel coverage?YesYes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit changes

To change to family coverage or add a dependent: Within 60 days of the event

To change plans or cancel: Within 30 days of the event

To enroll: Within 60 days of the event

To change or cancel: Within 30 days of the event

How to submit changesSubmit the Health Insurance Application/Change for Retirees (ET-2331) with required documentation to ETF.Submit the Supplemental Insurance Application/Change (ET-2339) with required documentation to ETF.
Documentation required?YesYes
Effective date

New dependent coverage: Effective on the first of the month on or after receipt of the application, or the date specified on the NMSN, if one is specified

Plan change: Effective the first of the month on or after the receipt of the application

Canceling coverage: Effective the last day of the month following receipt of the application

New dependent coverage: Effective on the first of the month on or after receipt of the application, or the date specified on the NMSN, if one is specified

Coverage change: Effective on the date of the event

Canceling coverage: Effective the last day of the month following receipt of the application

Paternity - Retirees

 Health Insurance & Uniform DentalSupplemental Benefits
Enrollment opportunity?NoYes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?YesYes
Change coverage from family to individual?YesNo
Change health plan?Yesn/a
Drop a dependent and keep family coverage?NoNo
Cancel coverage?YesYes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit changesTo change to family coverage or add a dependent: Within 60 days of the event. Children born outside of marriage become dependents of the father on the date of the court order declaring paternity, on the date the acknowledgment of paternity is filed with the Department of Health Services (or equivalent if the birth was outside of the state of Wisconsin), or on the date of birth with a birth certificate listing the father's name

To change plans or cancel: Within 30 days of the event

To enroll: Within 60 days of the event

To cancel or change: Within 30 days of the event

How to submit changesSubmit the Health Insurance Application/Change for Retirees (ET-2331) with required documentation to ETF.Submit the Supplemental Insurance Application/Change (ET-2339) with required documentation to ETF.
Documentation required?YesYes
Effective date

Birth certificate or statement of paternity is filed within 60 days of birth: Family coverage is effective on date of birth

Application is filed more than 60 days after birth, without a birth certificate: Family coverage is effective on the first of the month following the receipt of application

Plan change: Effective the first of the month on or after the receipt of the application

Canceling coverage: Effective the last day of the month following receipt of the application

Birth certificate or statement of paternity is filed within 60 days of birth: Coverage is effective on date of birth

Application is filed more than 60 days after birth, without a birth certificate: Coverage is effective on the first of the month following the receipt of application

Canceling coverage: Effective the last day of the month following receipt of the application

 Health Insurance & Uniform DentalSupplemental Benefits
Enrollment opportunity?NoYes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?YesYes
Change coverage from family to individual?YesNo
Change health plan?Yesn/a
Drop a dependent and keep family coverage?NoNo
Cancel coverage?YesYes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit changesTo change to family coverage or add a dependent: Within 60 days of the event

To change plans or cancel: Within 30 days of the event

To enroll: Within 60 days of the event

To change or cancel: Within 30 days of the event

How to submit changesSubmit the Health Insurance Application/Change for Retirees (ET-2331) with required documentation to ETF.Submit the Supplemental Insurance Application/Change (ET-2339) with required documentation to ETF.
Documentation required?YesYes
Effective date

Change to family coverage or adding a dependent: Effective on the date of the event

Plan change: Effective the first of the month on or after the receipt of the application

Canceling coverage: Effective the last day of the month following receipt of the application  

New coverage: Effective on the date of the event

Canceling coverage: Effective the last day of the month following receipt of the application   

Custody Transfer - Retirees

 Health Insurance & Uniform DentalSupplemental Benefits
Enrollment opportunity?NoYes. For members currently not enrolled, member must include the new dependent as part of the enrollment (can not enroll with individual coverage)
Change coverage from individual to family?YesYes
Change coverage from family to individual?YesNo
Change health plan?Yesn/a
Drop a dependent and keep family coverage?NoNo
Cancel coverage?YesYes, must provide proof you gained coverage comparable to the supplemental plan in which the employee is canceling
Deadline to submit changesWithin 30 days of the eventWithin 30 days of the event
How to submit changesSubmit the Health Insurance Application/Change for Retirees (ET-2331) with required documentation to ETF.Submit the Supplemental Insurance Application/Change (ET-2339) with required documentation to ETF.
Documentation required?YesYes
Effective date

Change to family coverage or adding a dependent: Effective on the date of the event

Plan change: Effective the first of the month on or after the receipt of the application

Canceling coverage: Effective the last day of the month following receipt of the application

New coverage: Effective on the date of the event

Canceling coverage: Effective the last day of the month following receipt of the application